Lung cancer in patients with pulmonary fibrosis: characteristics features and prognosis
Main Article Content
Keywords
pulmonary fibrosis, idiopathic pulmonary fibrosis, lung cancer, radiology, histology, mortality
Abstract
Background and aim: Lung cancer is one of the significant comorbidities seen in patients with Idiopathic Pulmonary Fibrosis (IPF). However, there is limited data on non-IPF Pulmonary Fibrosis (PF) patients with lung cancer (LC). The present study aims to compare the characteristics and survival outcomes of patients diagnosed with LC in IPF and non-IPF PF.
Methods: The multicenter data records of IPF and non-IPF PF patients diagnosed with lung cancer between 2010- 2022 were analyzed in this descriptive, cross-sectional, and retrospective study.
Results: Of the 251 patients involved in this study [164 IPF-LC, 87 non-IPF PF-LC], 89.6% were male, the mean age was 69±7.9 years and the smoking rate was 85.7%. Honeycomb pattern was more frequently observed in IPF-LC patients [62.8%,37.9%p<0.001], whereas ground-glass opacity [33.5%,59.8%p<0.001] and emphysema [37.8%,59.8%p<0.001] were more frequently seen in non-IPF PF-LC patients. The most commonly seen histological type was squamous cell carcinoma [42.7%,33.9%], followed by adenocarcinoma [28.2%; 32.2%]. [46.4%;47.2%] and their 5-year mortality rates were high [64.6%, 63.2%]. The median survival for both groups was 2±0.22 years [median 95% CI (1.55-2.44)]. The shortest survival time was observed in non-IPF PF-LC subgroup with unclassified PF [1±0.253 years median 95% CI (0.50-1.49) (p=0.030)].
Conclusions: The majority of IPF and non-IPF PF LC patients were male, elderly, and had a high smoking rate. Squamous cell carcinoma was the most frequently seen histological type and they had short survival periods and high mortality rates. The survival period of unclassified non-IPF PF-LC patients was found to be the shortest.
References
2. Meyer EC, Liebow AA. Relationship of interstitial pneumonia honeycombing and atypical epithelial proliferation to cancer of the lung. Cancer. 1965 mar;18:322-51.
3. Wells C, Mannino D.M, Pulmonary fibrosis and lung cancer in the United States: Analysis of the multiple cause of death mortality data, 1979 through 1991. South. Med J. 1996, 89, 505–510.
4. Hubbard R, Venn A, Lewis S, Britton J, Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am. J. Respir. Crit. Care Med.
5. Artinian V, Kvale P A, Cancer and interstitial lung disease. Curr. Opin. Pulm. Med. 2004, 10, 425–434.
6. Karampitsakos T, Tzilas V, Tringidou R, et al. Lung cancer in patients with idiopathic pulmonary fibrosis. Pulm. Pharmacol. Ther. 2017, 45,1–10.
7. Turner-Warwick M, Lebowitz M, Burrows B, Cryptogenic fibrosing alveolitis and lung cancer. Thorax 1980; 35:496-9.
8. Matsushita H, Tanaka S, Saiki Y, et al. Lung cancer associated with usual interstitial pneumonia. Pathol Int 1995; 45:925-32.
9. Ozawa Y, Suda T, Naito T, et al. Cumulative incidence of and predictive factors for lung cancer in IPF. Respirology2009, 14, 723–728.
10. Kato E, Takayanagi N, Takaku Y, et al. Incidence and predictive factors of lung cancer in patients with idiopathic pulmonary fibrosis. ERJ Open Res. 2018, 4, 00111-2016.
11. Lee T, Park J.Y, Lee HY, et al. Lung cancer in patients with idiopathic pulmonary fibrosis: Clinical characteristics and impact on survival. Respir Med 2014; 108:1549-55.
12. Tomassetti S, Gurioli C, Ryu JH, et al. The impact of lung cancer on survival of idiopathic pulmonary fibrosis. Chest. 2015; 147:157–64.
13. Lee CT, Kang KH, Koh Y, et al. Characteristics of lung cancer in Korea. Lung Cancer 1997;2000(30):15-22.
14. Kim YC, Kwon YS, Oh IJ, et al. National survey of lung cancer in Korea, 2005. J Lung Cancer AID 2007; 6:67-73.
15. Aubry MC, Myers JL, Douglas WW, et al. Primary pulmonary carcinoma in patients with idiopathic pulmonary fibrosis. Mayo Clin. Proc. 2002, 77, 763–770.
16. Kreuter M, Ehlers-Tenenbaum S, Schaaf M, et al. Treatment and outcome of lung cancer in idiopathic interstitial pneumonias. Sarcoidosis Vasc. Diffus. Lung Dis. Off. J. WASOG 2015, 31, 266–274.
17. Yoon JH, Nouraie M, Chen X, et al. Characteristics of lung cancer among patients with idiopathic pulmonary fibrosis and interstitial lung disease Analysis of institutional and population data. Respir. Res. 2018, 19, 195.
18. Cottin V, Nunes H, Mouthon L, et al. Combined pulmonary fibrosis and emphysema syndrome in connective tissue disease. Arthritis Rheum 2011; 63:295-304.
19. Enomoto Y, Inui N, Yoshimura K, et al. Lung cancer development in patients with connective tissue disease-related interstitial lung disease: A retrospective observational study. Medicine (Baltimore). 2016 Dec;95(50):e5716.
20. American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med. 2000 Feb;161(2 Pt 1):646-64.
21. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010 Sep;69(9):1580-8. Erratum in: Ann Rheum Dis. 2010 Oct;69(10):1892.
22. Aletaha D, Neogi T, Silman AJ, et al. American College of Rheumatology classification criteria for Sjögren’s syndrome: a data- driven, expert consensus approach in the Sjögren’s International Collaborative Clinical Alliance cohort. Arthritis Care Res (Hoboken) 2012; 64:475–87.
23. Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum. 2012 Aug;64(8):2677-86.
24. Travis WD, Brambilla E, Nicholson AG, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015; 10:1243–60.
25. Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: Proposals for the revision of the TNM stage groupings in the forthcoming (Eighth) edition of the TNM classification for lung cancer. J Thorac Oncol 2016; 11: 39-51
26. Ley B, Collard HR, King TE, Jr. Clinical course and prediction of survival in idiopathic pulmonary fibrosis. Am. J. Respir. Crit. Care Med. 2011, 183, 431–440.
27. Watanabe S, Saeki K, Waseda Y, et al. Lung cancer in connective tissue disease-associated interstitial lung disease: clinical features and impact on outcomes. J Thorac Dis 2018;10(2):799-807
28. Raghu G, Remy-Jardin M, Richeldi L, et al. Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2022; 205: Iss 9, 18–47.
29. Calio A, Lever V, Rossi A, et al. Increased frequency of bronchiolar histotypes in lung carcinomas associated with idiopathicpulmonary fibrosis. Histopathology 2017, 71, 725–735.
30. Kara S, Akçay S, Koç Z. Characteristics of Lung Cancer in Patients with Idiopathic Pulmonary Fibrosis and Interstitial Lung Disease: A Comparative Analysis. J Oncol Res Ther 2020 5: 1096.
31. Dela Cruz CS, Tanoue LT, Matthay RA, Lung cancer: Epidemiology, etiology, and prevention. Clin. Chest Med. 2011, 32, 605–644.
32. Chanda D, Otoupalova E, Smith SR, Volckaert T, De Langhe SP, Thannickal VJ, Developmental pathways in the pathogenesis of lung fibrosis. Mol. Asp. Med. 2019, 65, 56–69.
33. Kreuter M, Ehlers-Tenenbaum S, Schaaf M, et al. Treatment and outcome of lung cancer in idiopathic interstitial pneumonias. Sarcoidosis Vasc Diffuse Lung Dis. 2015 Jan 5;31(4):266-74.
34. Samarelli AV, Masciale V, Aramini B, et al. Molecular Mechanisms and Cellular Contribution from Lung Fibrosis to Lung Cancer Development Int. J. Mol. Sci. 2021, 22, 12179.
Article Sidebar
Article Details
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
